General and more comprehensive text about cancer diseases, their behavior, causes and treatment can be found here.
Testicular cancer is a term for a large and variable group of malignant tumors that arise from the tissue of testicles. They are less common in older males, but they typically occur in younger men between 30 and 50 years of age. When diagnosed in time, these tumors are well-treatable and have an overall good prognosis.
The testicle is a paired male sexual gland. The testicles are formed during the embryonic development within the abdomen, but they descend into scrotum. This is necessary, because they need lower temperature for proper function including sperm production. The testes contain three basic types of cells – Leydig, Sertoli and stem cells. Leydig cells produce the male sex hormone testosterone, which to some extent affects the behavior of men. Sertoli cells are important for proper maturation of male gametes - the sperm cells. Sertoli cells care for the sperm cells and ensure their nutrition. Stem cells within the testicles are the cells that give birth to sperm cells.
All mentioned cells may become sources of malignant tumors. The majority of tumors grows from the stem cells, but some cancers may develop from the Sertoli and Leydig cells. The classification of these tumors is very complex and there are many cancer types including seminoma, yolk sac tumors, choriocarcinomas, embryonic carcinomas, and many others. However, this is not important for general understanding.
The genetics certainly plays an important role together with some outer factors including testicular injuries, chronic infections and condition known as undescended testicle (cryptorchidism). The cryptorchidism means that one or both testicles do not descend and remain in the abdominal cavity. When the persisting cryptorchidism is not solved surgically, the testicle (or both testicles) in the abdominal cavity loses forever the ability to produce sperm and in addition, it has a significantly increased risk of cancer development. Therefore, such irreversibly damaged testicle should be surgically removed.
Testicular cancer usually manifests with a painless enlargement of the affected testicle that is perceived as enlarged scrotum. This must be considered as a serious symptom and any young man should immediately consult a doctor, in ideal case a urologist. Locally spread tumor may cause enlargement of abdominal lymph nodes and distant metastases cause classic cancer symptoms such as fatigue, weight loss, slightly elevated temperature, night sweats and loss of appetite.
The doctor should carefully examine the enlarged scrotum. The best and accessible diagnostic method is ultrasound of the scrotal sac, which can reliably detect the tumor mass. Some testicular tumors may cause elevated blood levels of certain substances (we refer such substances to as tumor markers) and we can detect them from a sample of venous blood. Local and distant metastases may be visualized by computed tomography.
We can prevent the testicular cancers that occur due to cryptorchidism. Any case of cryptorchidism should be monitored and surgically solved. If this does not happen for some reason, the affected testicle should be removed.
The therapy depends on the local extent of the tumor and presence of distant metastases. Generally speaking, the tumor mass should be surgically removed, usually together with the affected testicle. Further approach depends on the exact type of tumor according to its histology. Usually, various combinations of chemotherapeutic agents are used with good results. The prognosis of the majority of testicular tumors is relatively good and complete curing is possible.